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US20100305978A1 - Automation of auditing claims - Google Patents

Automation of auditing claims
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Publication number
US20100305978A1
US20100305978A1US12/474,454US47445409AUS2010305978A1US 20100305978 A1US20100305978 A1US 20100305978A1US 47445409 AUS47445409 AUS 47445409AUS 2010305978 A1US2010305978 A1US 2010305978A1
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United States
Prior art keywords
word
words
insurance company
model
make
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US12/474,454
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US8447632B2 (en
Inventor
Dennis M. Hogan
Jeffrey J. Hogan
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Hyperquest LLC
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Hyperquest LLC
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Application filed by Hyperquest LLCfiledCriticalHyperquest LLC
Priority to US12/474,454priorityCriticalpatent/US8447632B2/en
Assigned to HYPERQUEST, INC.reassignmentHYPERQUEST, INC.ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS).Assignors: HOGAN, DENNIS M., HOGAN, JEFFREY J.
Assigned to HYPERQUEST, INC.reassignmentHYPERQUEST, INC.CORRECTIVE ASSIGNMENT TO CORRECT THE DOCKET NUMBER PREVIOUSLY RECORDED ON REEL 023104 FRAME 0550. ASSIGNOR(S) HEREBY CONFIRMS THE CORRECT DOCKET NUMBER IS HPQ-001B.Assignors: HOGAN, DENNIS M., HOGAN, JEFFREY J.
Publication of US20100305978A1publicationCriticalpatent/US20100305978A1/en
Assigned to SILICON VALLEY BANKreassignmentSILICON VALLEY BANKSECURITY AGREEMENTAssignors: HYPERQUEST, INC.
Application grantedgrantedCritical
Publication of US8447632B2publicationCriticalpatent/US8447632B2/en
Assigned to GOLDMAN SACHS BANK USA, AS COLLATERAL AGENTreassignmentGOLDMAN SACHS BANK USA, AS COLLATERAL AGENTSECURITY INTEREST (SEE DOCUMENT FOR DETAILS).Assignors: HYPERQUEST, INC.
Assigned to HYPERQUEST, LLC (F/K/A HYPERQUEST, INC.)reassignmentHYPERQUEST, LLC (F/K/A HYPERQUEST, INC.)RELEASE BY SECURED PARTY (SEE DOCUMENT FOR DETAILS).Assignors: GOLDMAN SACHS BANK USA
Assigned to HYPERQUEST, INC.reassignmentHYPERQUEST, INC.PAYOFF LETTER AND LIEN RELEASEAssignors: SILICON VALLEY BANK
Assigned to HYPERQUEST, LLCreassignmentHYPERQUEST, LLCCHANGE OF NAME (SEE DOCUMENT FOR DETAILS).Assignors: HYPERQUEST, INC.
Assigned to ALTER DOMUS (US) LLC, AS COLLATERAL AGENTreassignmentALTER DOMUS (US) LLC, AS COLLATERAL AGENTSECOND LIEN PATENT SECURITY AGREEMENTAssignors: AUDATEX NORTH AMERICA, LLC (F/K/A AUDATEX NORTH AMERICA, INC.), CLAIMS SERVICES GROUP, LLC, DMEAUTOMOTIVE LLC, EDRIVING FLEET LLC, ENSERVIO, LLC (F/K/A ENSERVIO, INC.), FINANCE EXPRESS LLC, HYPERQUEST, LLC (F/K/A HYPERQUEST, INC.), MOBILE PRODUCTIVITY, LLC, OMNITRACS, LLC, ROADNET TECHNOLOGIES, INC., SEE PROGRESS, LLC (F/K/A SEE PROGRESS, INC.), SMARTDRIVE SYSTEMS, INC., SOLERA HOLDINGS, LLC (F/K/A SOLERA HOLDINGS, INC.), XRS CORPORATION
Assigned to GOLDMAN SACHS LENDING PARTNERS LLC, AS COLLATERAL AGENTreassignmentGOLDMAN SACHS LENDING PARTNERS LLC, AS COLLATERAL AGENTFIRST LIEN PATENT SECURITY AGREEMENTAssignors: AUDATEX NORTH AMERICA, LLC (F/K/A AUDATEX NORTH AMERICA, INC.), CLAIMS SERVICES GROUP, LLC, DMEAUTOMOTIVE LLC, EDRIVING FLEET LLC, ENSERVIO, LLC (F/K/A ENSERVIO, INC.), FINANCE EXPRESS LLC, HYPERQUEST, LLC (F/K/A HYPERQUEST, INC.), MOBILE PRODUCTIVITY, LLC, OMNITRACS, LLC, ROADNET TECHNOLOGIES, INC., SEE PROGRESS, LLC (F/K/A SEE PROGRESS, INC.), SMARTDRIVE SYSTEMS, INC., SOLERA HOLDINGS, LLC (F/K/A SOLERA HOLDINGS, INC.), XRS CORPORATION
Assigned to GOLDMAN SACHS LENDING PARTNERS LLC, AS COLLATERAL AGENTreassignmentGOLDMAN SACHS LENDING PARTNERS LLC, AS COLLATERAL AGENTCORRECTIVE ASSIGNMENT TO CORRECT THE INCORRECT PATENT NUMBER D856640 PREVIOUSLY RECORDED ON REEL 056601 FRAME 0630. ASSIGNOR(S) HEREBY CONFIRMS THE FIRST LIEN PATENT SECURITY AGREEMENT.Assignors: AUDATEX NORTH AMERICA, LLC (F/K/A AUDATEX NORTH AMERICA, INC.), CLAIMS SERVICES GROUP, LLC, DMEAUTOMOTIVE LLC, EDRIVING FLEET LLC, ENSERVIO, LLC (F/K/A ENSERVIO, INC.), FINANCE EXPRESS LLC, HYPERQUEST, LLC (F/K/A HYPERQUEST, INC.), MOBILE PRODUCTIVITY, LLC, OMNITRACS, LLC, ROADNET TECHNOLOGIES, INC., SEE PROGRESS, LLC (F/K/A SEE PROGRESS, INC.), SMARTDRIVE SYSTEMS, INC., SOLERA HOLDINGS, LLC (F/K/A SOLERA HOLDINGS, INC.), XRS CORPORATION
Assigned to ALTER DOMUS (US) LLC, AS COLLATERAL AGENTreassignmentALTER DOMUS (US) LLC, AS COLLATERAL AGENTCORRECTIVE ASSIGNMENT TO CORRECT THE INCORRECT PATENT NUMBER D856640 PREVIOUSLY RECORDED ON REEL 056598 FRAME 0059. ASSIGNOR(S) HEREBY CONFIRMS THE SECOND LIEN PATENT SECURITY AGREEMENT.Assignors: AUDATEX NORTH AMERICA, LLC (F/K/A AUDATEX NORTH AMERICA, INC.), CLAIMS SERVICES GROUP, LLC, DMEAUTOMOTIVE LLC, EDRIVING FLEET LLC, ENSERVIO, LLC (F/K/A ENSERVIO, INC.), FINANCE EXPRESS LLC, HYPERQUEST, LLC (F/K/A HYPERQUEST, INC.), MOBILE PRODUCTIVITY, LLC, OMNITRACS, LLC, ROADNET TECHNOLOGIES, INC., SEE PROGRESS, LLC (F/K/A SEE PROGRESS, INC.), SMARTDRIVE SYSTEMS, INC., SOLERA HOLDINGS, LLC (F/K/A SOLERA HOLDINGS, INC.), XRS CORPORATION
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Abstract

Described are computer-based methods and apparatuses, including computer program products, for automation of auditing claims. A data file comprising make model information, insurance company information, and one or more auditable items, each auditable item comprising a word string having one or more words. The make model information is automatically translated into a vehicle identifier. The insurance company information is automatically translated into an insurance company identifier. The one or more auditable items are automatically translated into one or more groups of identifiers, wherein the one or more groups of identifiers comprises one or more part item identifiers, one or more operational item identifiers, or both. A parts audit report is automatically generated based on the one or more groups of identifiers. An operational audit report is automatically generated. A multi-point estimate is automatically generated based on the parts audit report data and the operational audit report data.

Description

Claims (19)

1. A computerized auditing method comprising:
receiving, via a processor, a data file comprising make model information, insurance company information, and one or more auditable items, each auditable item comprising a word string having one or more words;
automatically translating, using the processor:
the make model information into a vehicle identifier;
the insurance company information into an insurance company identifier; and
the one or more auditable items into one or more groups of identifiers, wherein the one or more groups of identifiers comprises one or more part item identifiers, one or more operational item identifiers, or both;
automatically generating, using the processor, a parts audit report based on the one or more groups of identifiers, the parts audit report comprising data indicative of whether one or more parts of the one or more auditable items is accepted based on one or more rules associated with the insurance company identifier;
automatically generating, using the processor, an operational audit report based on the one or more groups of identifiers, the operational audit report comprising data indicative of whether one or more operations of the one or more auditable items is accepted based on one or more rules associated with the insurance company identifier; and
automatically generating, using the processor, a multi-point estimate based on the parts audit report data and the operational audit report data.
2. The method ofclaim 1 wherein automatically translating the make model information into a vehicle identifier comprises, for each word string comprising make model information, wherein the make model information comprises one or more make fields and one or more model fields:
preparing the one or more model fields for translation by:
applying one or more rules from a plurality of rules; and
associating each field of the one or more model fields with a class from a list of classes;
preparing the one or more make fields for translation by applying one or more rules from the plurality of rules;
associating each field of the one or more make fields with one or more make model entries from a plurality of predetermined make model entries;
associating each field of the one or more model fields with one or more make model entries from the plurality of predetermined make model entries; and
automatically translating the word string into one or more vehicle identifiers based on the associated make model entries.
17. An apparatus comprising:
an auditing system configured to receive a data file comprising make model information, insurance company information, and one or more auditable items, each auditable item comprising a word string having one or more words;
a make model translator in communication with the auditing system configured to automatically translate the make model information into a vehicle identifier;
an insurance company name translator in communication with the make model translator configured to automatically translate the insurance company information into an insurance company identifier;
a parts translator in communication with the insurance company name translator configured to automatically translate the one or more auditable items into one or more groups of identifiers, wherein the one or more groups of identifiers comprises one or more part item identifiers, one or more operational item identifiers, or both; and
an output unit in communication with the auditing apparatus configured to:
automatically generate a parts audit report based on the one or more groups of identifiers, the parts audit report comprising data indicative of whether one or more parts of the one or more auditable items is accepted based on one or more rules associated with the insurance company identifier;
automatically generate an operational audit report based on the one or more groups of identifiers, the operational audit report comprising data indicative of whether one or more operations of the one or more auditable items is accepted based on one or more rules associated with the insurance company identifier; and
automatically generate a multi-point estimate based on the parts audit report data and the operational audit report data.
18. A computer program product, tangibly embodied in a computer readable storage medium, the computer program product including instructions being operable to cause a data processing apparatus to:
receive a data file comprising make model information, insurance company information, and one or more auditable items, each auditable item comprising a word string having one or more words;
automatically translate:
the make model information into a vehicle identifier;
the insurance company information into an insurance company identifier; and
the one or more auditable items into one or more groups of identifiers, wherein the one or more groups of identifiers comprises one or more part item identifiers, one or more operational item identifiers, or both;
automatically generate a parts audit report based on the one or more groups of identifiers, the parts audit report comprising data indicative of whether one or more parts of the one or more auditable items is accepted based on one or more rules associated with the insurance company identifier;
automatically generate an operational audit report based on the one or more groups of identifiers, the operational audit report comprising data indicative of whether one or more operations of the one or more auditable items is accepted based on one or more rules associated with the insurance company identifier; and
automatically generate a multi-point estimate based on the parts audit report data and the operational audit report data.
19. An apparatus comprising:
means for receiving a data file comprising make model information, insurance company information, and one or more auditable items, each auditable item comprising a word string having one or more words;
means for automatically translating the make model information into a vehicle identifier;
means for automatically translating the insurance company information into an insurance company identifier;
means for automatically translating the one or more auditable items into one or more groups of identifiers, wherein the one or more groups of identifiers comprises one or more part item identifiers, one or more operational item identifiers, or both; and
means for:
automatically generating a parts audit report based on the one or more groups of identifiers, the parts audit report comprising data indicative of whether one or more parts of the one or more auditable items is accepted based on one or more rules associated with the insurance company identifier;
automatically generating an operational audit report based on the one or more groups of identifiers, the operational audit report comprising data indicative of whether one or more operations of the one or more auditable items is accepted based on one or more rules associated with the insurance company identifier; and
automatically generating a multi-point estimate based on the parts audit report data and the operational audit report data.
US12/474,4542009-05-292009-05-29Automation of auditing claimsActive2030-07-05US8447632B2 (en)

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